Cardiac massage apparatus and method

Abstract

A device for performing minimally invasive closed chest heart massage comprises a support having a plurality of curved, deployable struts, optionally carrying a sheet or inflatable bladder for engaging the pericardium. The struts are delivered to the space between the pericardium and the posterior rib cage in a radially collapsed configuration and deployed radially outwardly with minimum advancement in the axial direction.

What is claimed is:  
     
       1. A cardiac massage device comprising: 
       a sleeve;  
       a shaft having an axis, a proximal end and a distal end slidably mounted in the sleeve; and  
       a flared bell structure attached to the distal end of the shaft, wherein the bell structure is collapsible so that it can be drawn into the sleeve by proximally retracting the shaft and expanded by distally, advancing the shaft,  
       wherein the flared bell structure comprises a plurality of flexible struts, wherein each strut has an unconstrained configuration characterized by an arcuate geometry with a proximal end attached to the shaft and a distal region curved outwardly at an angle in the range from 45° to 135° relative to the shaft axis; and  
       at least some of the struts include reinforcing beams having one end attached near the proximal end of the strut and another end attached proximally of the distal end of the strut.  
     
     
       2. A cardiac massage device as in claim  1 , wherein the other end of the beam is attached at a point located from 15% to 50% of the strut length from the distal end of the strut. 
     
     
       3. A cardiac massage device as in claim  1 , further comprising a blunt cap which is removably disposed over a distal end of the sleeve when the flared bell structure is retracted into the sleeve. 
     
     
       4. A cardiac massage device as in claim  3 , further comprising a rod slidably mounted within the shaft, wherein the blunt cap is attached to a distal end of the rod. 
     
     
       5. A cardiac massage device as in claim  1 , wherein the flared bell structure comprises a plurality of hinged struts with a distal and proximal segment. 
     
     
       6. A cardiac massage device as in claim  5 , wherein at least some of the struts have a third linkage attached at one end to the distal hinged segment, such that retraction of said third linkage relative to the proximal hinged segment, causes radial separation of the distal hinged segment ends. 
     
     
       7. A cardiac massage device as in claim  1 , wherein the shaft has indicia on its outer surface indicating the relative position of the shaft and the sleeve. 
     
     
       8. A cardiac massage device as in claim  7 , wherein the indicia include at least one visible band showing when the shaft has advanced sufficiently to fully deploy the flared bell structure. 
     
     
       9. A cardiac massage device as in claim  7 , wherein the indicia include at least one visible band showing when the shaft has been retracted sufficient to close the flared bell structure an adequate amount to permit withdrawal of the device from the patient. 
     
     
       10. A cardiac massage device as in claim  1 , wherein a distal portion of the sleeve is compliant to facilitate retraction of the flared bell structure back into the sleeve. 
     
     
       11. A cardiac massage device as in claim  1 , further comprising a flange on the sleeve, wherein the flange is positioned a distance from the distal end of the sleeve which permits optimum deployment of the flared bell structure from said distal end when said flange engages the chest wall of the patient. 
     
     
       12. A cardiac massage device as in claim  11 , wherein the distance is in the range from 1 cm to 3 cm. 
     
     
       13. A cardiac massage device comprising: 
       a sleeve;  
       a shaft having an axis, a proximal end and a distal end slidably mounted in the sleeve; and  
       a flared bell structure attached to the distal end of the shaft, wherein the bell structure is collapsible so that it can be drawn into the sleeve by proximally retracting the shaft and expanded by distally, advancing shaft,  
       wherein the flared bell structure comprises a plurality of hinged struts each having a distal and proximal segment; and  
       wherein at least some of the struts have a third linkage attached at one end of the distal hinged segment, such that retraction of said third linkage relative to the proximal hinged segment, causes radial separation of the distal hinged segment ends.  
     
     
       14. A cardiac massage device as in claim  1 , wherein the flared bell structure comprises a plurality of flexible struts, wherein each strut has an unconstrained configuration characterized by an arcuate geometry with a proximal end attached to the shaft and a distal region curved outwardly at an angle in the range from 45° to 135° relative to the shaft axis. 
     
     
       15. A cardiac massage device as in claim  14 , wherein at least some of the struts include reinforcing beams having one end attached near the proximal end of the strut and another end attached proximally of the distal end of the strut. 
     
     
       16. A cardiac massage device as in claim  15 , wherein the other end of the beam is attached at a point located from 15% to 50% of the strut length from the distal end of the strut. 
     
     
       17. A cardia massage device as in claim  1 , further comprising a blunt cap which is removably disposed over a distal end of the sleeve when the flared bell structure is retracted into the sleeve. 
     
     
       18. A cardiac massage device as in claim  17 , further comprising a rod slidably mounted within the shaft, wherein the blunt cap is attached to a distal end of the rod. 
     
     
       19. A cardiac massage device as in claim  13 , wherein the shaft has indicia on its outer surface indicating the relative position of the shaft and the sleeve. 
     
     
       20. A cardiac massage device as in claim  19 , wherein the indicia include at least one visible band showing when the shaft has advanced sufficiently to fully deploy the flared bell structure. 
     
     
       21. A cardiac massage device as in claim  19 , wherein the indicia include at least one visible band showing when the shaft has been retracted sufficient to close the flared bell structure an adequate amount to permit withdrawal of the device from the patient. 
     
     
       22. A cardiac massage device as in claim  21 , wherein the distance is in the range from 1 cm to 3 cm. 
     
     
       23. A cardiac massage device as in claim  13 , wherein a distal portion of the sleeve is compliant to facilitate retraction of the flared bell structure back into the sleeve. 
     
     
       24. A cardiac massage device as in claim  13 , further comprising a flange on the sleeve, wherein the flange is positioned a distance from the distal end of the sleeve which permits optimum deployment of the flared bell structure from said distal end when said flange engages the chest wall of the patient.